HARRIS INTEGRATED HEALTH AND NUTRITION
Welcome
Meet Dr. Harris
Do You Feel Lucky
Our Philosophy
Professional Affiliations
Paperwork
Health History
Digestive and Lifestyle Symptoms Assessment
Digestive Health Appraisal Questionairre
Female Hormone Self Assessment
Male Hormone Self Assessment
Medical Symptoms Questionaire
Nutritional Assessment
Gluten Sensitivity Assessment
Dairy Sensitivity
Toxin Exposure Assessment
Toxic Burden
Clinical Clues of Low Stomach Acid
Leaky Gut/Intestinal Permeability
>
Candida Assessment
Causes of Leaky Gut Syndrome
Programs
Eye to Eye
>
All Inclusive
Life in the Middle
Pay as You Go
From a Distance
>
All Inclusive
Life in the Middle
Pay as You Go
Diet Lifestyle Environment
Diet
Lifestyle
Environment
Resources
Book; Our Modern Mortal Trilogy
Detox and Meal Replacement
Comprehensive Elimination Diet
Daily/Weekly Physical Activity
Food Diary
>
Daily/Weekly Food Diary
Recipe's
>
Snacks/Appetizers/Soups
Entrees
>
Breakfast
Lunch
Dinner
Salads/Desserts
All Things Coconut
Out of the Box NEK TV
Newsletters
FAQ
A List of Lists
Answers to QUARA
Blog
Power Point Presentations
Cancer
Cancer
Male Hormone Self-Assessment
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Name
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Phone Number
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Today's Date
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Address
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Line 1
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City
State
Zip Code
Country
Occupation
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Height
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Email
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Weight
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Marital Status
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Single
Married
Divorced
Separated
Partner
Widow(er)
Date of Birth
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Number of Children
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General Information Male Reproductive Male Genital Health
Male Hormone Self Assessment
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Have a history of antibiotic use
Continuously use prescription medication
Take synthetic hormones in a topical cream, patch or orally
Have prostate problems
Experience difficulty sleeping
Experience mood swings
Experience low libido
Drink more than one glass of alcohol weekly
Drink caffeine daily
Experience exhaustion
Experience low sperm count
Experience penile erectile dysfunction
Experience infertility
Experience frequent urination
Male Hormone Self Assessment (cont)
*
Prostate trouble
Urination difficulty or dribbling
Frequent night urination
Pain on inside of legs or heels
Leg nervousness at night
Feeling of incomplete bowel evacuation
Tire easily/avoid activity
Reduced sex drive
Depression
Migrating aches and pains
Frequent or urgent need to urinate
delayed, weak or interrupted urinary stream
Pain or burning upon urination
Urge to urinate several times a night
Rose colored (bloody) urine
Difficulty urinating
A sense of bladder fullness
ejaculation causes pain
Blood in the semen
Lack of sex drive
Impotency
Pain or fatigue in the legs or back
Dripping after urination
Increased straining with small amounts of urine
Anemia
Current prostate enlargement or elevated PSA levels
Male Hormone Self Assessment (cont)
*
Itchy patches around inner thigh or groin
Itching at night
Painful testicles
Difficulty attaining and/or maintaining an erection
Low sexual drive
Premature ejaculation
Low energy level or stamina
Inflammation on the head of the penis
Genital and/or rectal rash or irritation
Distorted nail growth
Loss of pubic or armpit hair
Infertile
Low sperm count, low sperm motility
Unexplained weight gain
Testicles appear smaller
Development of breasts or nipple tenderness
feeling of heaviness or hardness in testicles
Sparse beard or slow hair growth
Decreased body hair
Fine wrinkling in corner of mouth and/or eyes
Current or recurrent epididimis
Submit
Welcome
Meet Dr. Harris
Do You Feel Lucky
Our Philosophy
Professional Affiliations
Paperwork
Health History
Digestive and Lifestyle Symptoms Assessment
Digestive Health Appraisal Questionairre
Female Hormone Self Assessment
Male Hormone Self Assessment
Medical Symptoms Questionaire
Nutritional Assessment
Gluten Sensitivity Assessment
Dairy Sensitivity
Toxin Exposure Assessment
Toxic Burden
Clinical Clues of Low Stomach Acid
Leaky Gut/Intestinal Permeability
>
Candida Assessment
Causes of Leaky Gut Syndrome
Programs
Eye to Eye
>
All Inclusive
Life in the Middle
Pay as You Go
From a Distance
>
All Inclusive
Life in the Middle
Pay as You Go
Diet Lifestyle Environment
Diet
Lifestyle
Environment
Resources
Book; Our Modern Mortal Trilogy
Detox and Meal Replacement
Comprehensive Elimination Diet
Daily/Weekly Physical Activity
Food Diary
>
Daily/Weekly Food Diary
Recipe's
>
Snacks/Appetizers/Soups
Entrees
>
Breakfast
Lunch
Dinner
Salads/Desserts
All Things Coconut
Out of the Box NEK TV
Newsletters
FAQ
A List of Lists
Answers to QUARA
Blog
Power Point Presentations
Cancer
Cancer